• Clinical and Experimental Reproductive Medicine
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• v.37 no.2
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• pp.135-142
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• 2010

Objective: To evaluate the effectiveness of soft stimulation protocol using GnRH antagonist/clomiphene citrate (CC)/recombinant FSH (rFSH) in patients undergoing controlled ovarian stimulation (COS) with intrauterine insemination (IUI), compared with GnRH antagonist multiple dose protocol (MDP) using GnRH antagonist/rFSH. Methods: Eighty infertile women were randomized to soft stimulation protocol group (n=40) or GnRH antagonist MDP group (n=40). In both groups, IUI was performed 36~40 hours after hCG injection. Statistical analysis was performed using Student's t-test, $\chi^2$ test or Fisher's exact test as appropriate. Results: Total dose and days of rFSH required for COS were significantly fewer in soft stimulation protocol group (p<0.001, p<0.001). A premature LH surge did not occur in any patients of both groups. Clinical pregnancy rate per cycle was similar between the two groups. Conclusion: Soft stimulation protocol provides comparable pregnancy rates to GnRH antagonist MDP despite fewer total dose and days of rFSH, and so can become one of the patient-friendly, cost-effective alternatives for infertile patients undergoing COS with IUI.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.2
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• pp.111-118
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• 2008

Objective: The purpose of the present study was to examine the hormonal regulation of RGS-2 in the rat ovary. Methods: Immature rats were injected with 10 IU of PMSG to induce multiple growth of preovulatory follicles and 10 IU of hCG to induce ovulation. Northern blot analysis performed for gene expression and in situ hybridization performed for mRNA localization. Results: Northern blot analysis revealed that pregnant mare's serum gonadotropin (PMSG) treatment did not affect RGS-2 mRNA levels. In contrast, human chorionic gonadotropin (hCG) treatment of PMSG-primed rats resulted in an increase in RGS-2 expression within $1{\sim}3\;h$. The major cell-types expressing RGS-2 mRNA were oocytes regardless of follicle size. Interestingly, hCG treatment caused the stimulation of RGS-2 gene expression in granulosa cells of preovulatory and growing follicles. In contrast, cell types expressing RGS-2 protein were theca cells regardless of hCG treatment. Like in vivo, treatment of preovulatory granulosa cells with LH in vitro stimulated RGS-2 levels within 1 h. Interestingly, GnRH antagonist II enhanced the stimulatory action of LH. Conclusion: The present study demonstrates the LH/hCG induction of RGS-2 in preovulatory granulosa cells and suggests a role of RGS-2 in Gq protein signaling pathway during ovulation.

• Clinical and Experimental Reproductive Medicine
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• v.28 no.1
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• pp.73-77
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• 2001

Objective: To report the pregnancy which was made by in vitro fertilization using recombinant follicle stimulating hormone and gonadotropin releasing hormone antagonist. Material and Method: Case report. Results: Six oocytes were retrieved and all were fertilized by intracytoplasmic sperm injection. Six embryos were transferred and the pregnancy was confirmed. Conclusion: It is envisaged that the availability of recombinant gonadotropins and gonadotropin releasing hormone antagonists will ultimately lead to shorter, cheaper and safer treatments, using reduced dosages.

• Clinical and Experimental Reproductive Medicine
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• v.36 no.1
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• pp.63-70
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• 2009

Objective: This study was performed to investigate the effectiveness of minimal stimulation using rhFSH and GnRH antagonist compared with GnRH antagonist multidose protocol (MDP) in IVF treated patients with aged 40 and above. Methods: Seventy-five patients with aged 40 and above were equally randomized to minimal stimulation group (n=37) or GnRH antagonist MDP group (n=38). For minimal stimulation group, ultrasound monitoring was started on cycle day 7 or 8. Daily injections of 0.25 mg cetrorelix together with 150 IU rhFSH were started from the day at 13${\sim}$14 mm of a leading follicle diameter. For GnRH antagonist MDP group, daily injections of 225 IU rhFSH were initiated from cycle day 2 and GnRH antagonist was started at a dose of 0.25 mg/day on rhFSH stimulation day 6 or the day at 13${\sim}$14 mm of leading follicle diameter. In both groups, transvaginal ultrasound-guided oocyte retrieval was performed. According to cleavage and morphologic characteristics of embryos, embryos were transferred 3 to 5 days after oocyte retrieval. Results: There were no differences in patients' characteristics and cycle cancellation rate between the two groups. Total dose and duration of rhFSH used were significantly fewer and shorter in minimal stimulation group than those in GnRH antagonist MDP group. The numbers of oocytes retrieved, mature oocytes and transferred embryos were also lower in minimal stimulation group. However, there were no significant differences in the clinical pregnancy rate and miscarriage rate between the two groups. Conclusions: This study demonstrates that minimal stimulation protocol provides comparable pregnancy rates to GnRH antagonist MDP with fewer dose and days of rhFSH used, and thus can be a cost-effective alternative in women aged 40 and above.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.3
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• pp.239-244
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• 2010

Objective: The objective of this retrospective study was to compare the in vitro fertilization (IVF) outcomes of gonadotropinreleasing hormone (GnRH) agonist and GnRH antagonist protocols in poor responders. Methods: A total of 172 cycles in subjects with less than 5 oocytes retrieved treated with either GnRH agonist long protocols or antagonist protocols were included. The outcome variables such as numbers of growing follicles and retrieved oocytes, and the fertilization rate were evaluated as the main outcome measures. Results: There was no difference in regard to the numbers of growing follicles and oocytes, and fertilization rate between the two groups. $E_2$ level on Day 7/8, mean gonadotropin dose, and the days of stimulation were shown to be statistically different (p<0.01, respectively). Conclusion: Considering that similar results were observed with less time and gonadotropin dose, GnRH antagonist protocol may be considered as a preferable choice over GnRH agonist protocols in poor responders.